Mental Health: When biology is partly to blame

“You need help!” This statement is used in an attempt to convince someone to seek psychological treatment.

 A statement of concern in itself, although often misused as dismissive language. There has been increasing mental health awareness in Kenya in recent years.

According to the 2019 inaugurated Taskforce on Mental Health, majority of Kenyans associate mental health and illness with negative narratives. This, in turn, leads to reduced focus on mental wellbeing.

The Ministry of Health estimates that one in every 10 Kenyans suffers from a form of mental disorder. The statistics increase to one in every four people among those seeking outpatient care in health facilities.

Women, relationships and mental health

Our associations have a significant impact on mental health. Is marriage or any form of relationship good for a woman’s mental wellbeing? How about motherhood — with or without marriage?

Prof Sangeetha Madhavan of African American Studies and Sociology highlights that the hard work of stabilising a union consequentially affects mental health in women.

In a publication, Prof Sangeetha says: “The hard work of establishing trust with a partner, gaining respect from kin and securing financial support can be quite stressful.”

She continues to say, “Without coming to light and being accepted by family, building a relationship with the other family and securing financial support, a woman will be left isolated and insecure, a recipe for poor mental wellbeing.”

Interestingly, a study she conducted in Korogocho, Nairobi, found that women who experienced a high level of emotional support from men generally had low-stress levels. This means that under certain circumstances, relationships with men offer a cushioning effect from mental illness for women.

Depression

According to the World Health Organisation, depressive disorders account for close to 41.9 per cent of the disability from neuropathic disorders among women compared to 29.3 per cent in men.

Depression is characterised by an overwhelming sorrow, loss of enthusiasm and feeling of worthlessness that may last for days or weeks or chronic, lasting for months or even years.

Hormonal fluctuations across a woman’s life span have a significant impact on mental health. Oestrogen, the main female sex hormone has been found to provide some level of protection against mental illness.

It goes without saying that shifting oestrogen levels interplay with the mental state. Pre-menstrual and menopause are times when oestrogen levels are lower and women are likely to experience premenstrual dysphoric disorder a week before menstruation and notable depression or anxiety during menopause.

Additionally, it has been published in PubMed that men have higher levels of serotonin — happy hormone — compared to women. This is because women tend to absorb the hormone faster than men, making them more susceptible to mood swings.

Bipolar disorder

Also known as manic-depressive illness, Bipolar disorder causes changes in a person’s mood and energy levels to an extremity of interfering with their ability to function.

According to the Africa Mental Health Research and Training Foundation, people with bipolar disorder experience periods of normal moods with interrupted episodes of extreme emotional states such as overly energised sessions and sad or sluggish moments.

A person could be ecstatic for a moment and talk a lot about random issues before shutting everyone out. Then they become quiet and seem out of touch. Bipolar disorder is categorised in four types:

1.    Bipolar I Disorder: manic and depressive episodes that persist for a week, leading to inevitable hospitalisation.

2.    Bipolar II Disorder: depressive episodes with least manic moments.

3.    Bipolar Disorder Not Otherwise Specified: when criteria do not fit for either bipolar I or II.

4.    Cyclothymic Disorder: A mild form of mixed episodes that has persisted for over two years.

There is scientific evidence that shows that Bipolar II, which is predominantly depressive, occurs more in women than men.

There is a treatment that helps patients to manage the condition in order to function normally. Youth and Gender Chief Administrative Secretary Rachel Shebesh made public her journey with bipolar disorder.

In a video shared on her social media, Shebesh said: “I take medicine for bipolar and I take medicine for depression. Bipolar does not control me; it is just a part of who I am.”

Treatment in women is challenged by pregnancy and lactation. The available mood stabilisers are contraindicated in pregnancy and lactation since they can cause harm to the foetus and infant. Pregnancy and lactation periods are high-risk times for recurrence of bipolar disorder.